Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 208392 | TX |
NPI | 1013497767 |
---|---|
Provider Name | Mrs. Sherri Lynn Berry |
First Address | Groesbeck, TX 76642-2642 |
Second Address | Ennis, TX 75119-6841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2018 |
Last Update Date | 21/08/2018 |